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General NPI Number Information
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NPI Number | 1326382458
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Entity Type | Individual
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Provider Name | LEANNE KING BACHELOR
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Gender | Female
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 6033 N SHERIDAN RD #22E
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City | CHICAGO
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State | IL
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Zip | 60660-3003
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Country | US
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Telephone | 217-416-5453
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 N CLYBOURN AVE #302
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City | CHICAGO
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State | IL
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Zip | 60618-8187
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Country | US
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Telephone | 217-416-5453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056009726
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License Number State | IL
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